Degenerative Left Shift as a Prognostic Tool in Cats

Background

A degenerative left shift (DLS) is reported to be a poor prognostic indicator in dogs and cats. Limited data in dogs and no studies in cats have been published to investigate this claim.

Hypothesis/Objectives

To characterize the feline population affected by DLS and to determine if the presence and severity of DLS are associated with increased risk of euthanasia or death.

Animals

One hundred and eight cats with DLS (cases) and 322 cats without DLS (controls) presented to the University of California, Davis Veterinary Medical Teaching Hospital between April 1, 1995 and April 1, 2010.

Methods

Retrospective case–control study. All cases had a CBC performed within 24 hours of presentation in which immature granulocytic precursors exceeded mature neutrophils. Controls were matched by year of presentation and primary diagnosis. Survival analysis was used to determine risk of death or euthanasia from DLS and other potential predictors of outcome.

Results

Cases were more likely to die or be euthanized in hospital compared to controls (60/108 [56%] versus 107/322 [33%]). DLS was a significant predictor of death or euthanasia in hospitalized cats in both univariate and multivariate analysis (hazard ratio, 1.57; 95% confidence interval, 1.13–2.18). Trend analysis showed an increasing trend in the hazard of euthanasia or death with increasing severity of DLS.

Conclusions and Clinical Importance

Cats with DLS are 1.57 times more likely to die or be euthanized in hospital than cats without DLS. In addition, increasing severity of DLS is associated with increased likelihood of death or euthanasia.     

Association of Blood Monocyte and Lymphocyte Count and Disease‐Free Interval in Dogs with Osteosarcoma

Background: Identification of biomarkers that predict outcomes in dogs with osteosarcoma (OSA) would be valuable to veterinarians and owners. Leukocyte numbers in peripheral blood are associated with outcomes in some types of cancer in humans. Hypothesis/Objectives: We hypothesized that increased numbers of monocytes would be associated with reduced disease‐free interval (DFI) in dogs with OSA. Animals: Medical data from 69 dogs with appendicular OSA treated with amputation and chemotherapy were selected for study. Methods: Retrospective study. Statistical associations were assessed by univariate and multivariate analysis. Information about DFI and leukogram values, tumor location, and serum alkaline phosphatase was abstracted from the medical record. Results: Higher numbers of circulating monocytes (>0.4 × 10³ cells/μL) and lymphocytes (>1.0 × 10³ cells/μL) before treatment were found to be significantly (P < .05) associated with shorter DFI in dogs with OSA. Other parameters associated with poor outcomes were increased alkaline phosphatase, primary tumor location, and age. Conclusion and Clinical Importance: These results indicated that pretreatment evaluation of monocyte and lymphocyte counts provided prognostic information for dogs with appendicular OSA. Notably, most animals in this study had monocyte counts within the normal reference range, indicating that variations within the reference range of leukocyte values might also have prognostic significance.     

Clinical Severity Score System in Dogs with Degenerative Mitral Valve Disease

Background

Several risk factors already have been determined for dogs with degenerative mitral valve disease (DMVD). Risk factors often have been considered in isolation and have not always taken into account additional information provided by the history and physical examination (PE).

Hypothesis/Objectives

Data obtained from history and PE of dogs with DMVD provide prognostic information and can be used for risk stratification.

Animals

Client‐owned dogs (n = 244) with DMVD recruited from first opinion practice.

Methods

Prospective longitudinal follow‐up of dogs with DMVD. History and PE data were obtained at 6‐month intervals and analyzed with time‐dependent Cox models to derive relative risk of cardiac death. Independent hazard ratios were used to derive a clinical severity score (CSS), the prognostic value of which was evaluated by analyzing the median survival times for different risk groups and ROC analysis. Analysis of the progression of CSS over time also was undertaken.

Results

History of cough, exercise intolerance, decreased appetite, breathlessness (difficulty breathing) and syncope with PE findings of heart murmur intensity louder than III/VI and absence of respiratory sinus arrhythmia were independently associated with outcome and allowed development of the CSS. Clinical severity score distinguished groups of dogs with significantly different outcomes.

Conclusions and Clinical Importance

Routinely obtained clinical findings allow risk stratification of dogs with DMVD. Results of ancillary diagnostic tests may be complementary to history and PE findings and always should be interpreted in conjunction with these findings.     

Ascites is a Negative Prognostic Indicator in Chronic Hepatitis in Dogs

Background: Chronic hepatitis (CH) in dogs is common but little is known about factors associated with survival. Ascites is a well-recognized negative prognostic indicator in humans.
Hypothesis: Ascites is a negative prognostic indicator in CH in dogs.
Animals: Thirty-four dogs with histologically confirmed CH presented to 1 institution between 1996 and 2005.
Methods: Retrospective observational study. CH was diagnosed by histopathology of liver tissue according to the WSAVA criteria. Ascites was diagnosed by abdominal ultrasound. The association of ascites with survival from diagnosis or onset of owner-reported clinical signs until death from any cause or from liver disease was analyzed. Ascitic and nonascitic groups were further analyzed for differences in treatment and sex.
Results: Fourteen of 34 dogs had ascites. Survival from diagnosis to death from liver disease was 0.4 months (95% confidence interval [CI], 0.2–0.6) for ascitic dogs and 24.3 months (CI 11.4–37.1) for nonascitic dogs ( P < .001), and from onset of signs to death from liver disease was 2.0 months (CI 0.0–5.6) for ascitic dogs and 33.0 months (CI 8.6–57.4) for nonascitic dogs ( P = .0020). Diet and spironolactone use differed between groups.
Conclusions and Clinical Importance: Ascites is a significant negative prognostic indicator in dogs with CH. Veterinarians and owners can use this information to aid clinical decision making in affected dogs.     

The Prognostic Value of Perioperative Profiles of ACTH and Cortisol for Recurrence after Transsphenoidal Hypophysectomy in Dogs with Corticotroph Adenomas

Background

Transsphenoidal hypophysectomy is an effective treatment for dogs with pituitary‐dependent hypercortisolism (PDH). However, long‐term recurrence of hypercortisolism is a well‐recognized problem, indicating the need for reliable prognostic indicators.

Objectives

The aim of this study was to evaluate the prognostic value of perioperative plasma ACTH and cortisol concentrations for identifying recurrence of hypercortisolism after transsphenoidal hypophysectomy.

Animals

A total of 112 dogs with PDH that underwent transsphenoidal hypophysectomy met the inclusion criteria of the study.

Methods

Hormone concentrations were measured preoperatively and 1–5 hours after surgery. Both absolute hormone concentrations and postoperative concentrations normalized to preoperative concentrations were included in analyses. The prognostic value of hormone concentrations was studied with Cox''s proportional hazard analysis.

Results

Median follow‐up and disease‐free period were 1096 days and 896 days, respectively. Twenty‐eight percent of patients had recurrence, with a median disease‐free period of 588 days. Both absolute and normalized postoperative cortisol concentrations were significantly higher in dogs with recurrence than in dogs without recurrence. High ACTH 5 hours after surgery, high cortisol 1 and 4 hours after surgery, high normalized ACTH 3 hours after surgery, high normalized cortisol 4 hours after surgery and the random slope of cortisol were associated with a shorter disease‐free period.

Conclusions and clinical importance

Individual perioperative hormone curves provide valuable information about the risk of recurrence after hypophysectomy. However, because no single cutoff point could be identified, combination with other variables, such as the pituitary height/brain area (P/B) ratio, is still needed to obtain a good estimate of the risk for recurrence of hypercortisolism after hypophysectomy.     

Prognostic Value of Left Atrial Function in Dogs with Chronic Mitral Valvular Heart Disease

Background

A strong correlation between left atrial (LA) dysfunction and the severity of cardiac disease has been described in human patients with various cardiac diseases. The role of LA dysfunction in dogs with chronic mitral valvular heart disease (CMVHD) has not been addressed.

Objectives

To investigate the correlation between LA function and the prognosis of dogs with CMVHD.

Animals

Thirty‐eight client‐owned dogs with CMVHD.

Methods

Prospective clinical cohort study. Dogs were divided into 2 groups (survivors and nonsurvivors) based on the onset of cardiac‐related death within 1 year. Physical examination and echocardiographic variables were compared between the groups. For the assessment of the comparative accuracy in identifying patients with cardiac‐related death, receiver operating characteristic (ROC) curves and multivariate logistic analysis were used.

Results

The highest accuracy was obtained for the LA active fractional area change (LA‐FAC _act), with an area under the ROC curve (AUC) of 0.95, followed by the left atrial to aortic root ratio (LA/Ao), with an AUC of 0.94; peak early diastolic mitral inflow velocity (E), with an AUC of 0.85; and LA total fractional area change (LA‐FAC _total), with an AUC of 0.85. In the multivariate logistic regression analysis, LA‐FAC _act emerged as the only independent correlate of cardiac‐related death within 1 year (odds ratio = 1.401, P = .002).

Conclusions and Clinical Importance

Regarding both the size and function, the LA has a strong correlation with the prognosis of dogs with CMVHD. The most significant independent predictor of mortality in this study was LA‐FAC _act.     

Hematology of the sandbar shark, Carcharhinus plumbeus: standardization of complete blood count techniques for elasmobranchs

BACKGROUND: Standardized hematologic methods and reference intervals have not been established for cartilaginous fishes (sharks, skates, and rays) despite the large number of animals displayed in zoos and aquariums worldwide. OBJECTIVE: The focus of this study was to validate CBC methods for sandbar shark (Carcharhinus plumbeus) blood, based on criteria established in human medicine, for the following tests: RBC count, total WBC count, PCV, hemoglobin (Hgb) concentration, and WBC differential percentages. METHODS: Replicate CBCs were performed using blood samples from 5 captive sandbar sharks. Three protocols for RBC and total WBC counts were compared, as were different centrifugation times for PCV determination, and 2 methods for Hgb concentration. Means, minimum and maximum values, and CVs were compared to CAP and CLIA performance guidelines for human tests. RESULTS: Total WBC counts in a diluent modified for elasmobranch blood, Hgb concentration by the cyanmethemoglobin method after removal of nuclei, and WBC differential percentages showed acceptable performance. PCV results were acceptable when tubes were centrifuged for at least 5 minutes. Total RBC counts by all 3 methods exceeded the acceptable error for manual counts of human cells. CONCLUSIONS: Standardized CBC tests can be used as health assessment tools for elasmobranchs. Total RBC counts should be viewed as estimates.     

Gallbladder Mucocele: Variables Associated with Outcome and the Utility of Ultrasonography to Identify Gallbladder Rupture in 219 Dogs (2007–2016)

Background

Gallbladder mucocele (GBM) is an increasingly recognized extrahepatic biliary disease in dogs.

Objectives

To investigate cases of GBM and identify variables associated with survival and the sensitivity and specificity of ultrasonography to identify gallbladder rupture.

Animals

Two hundred and nineteen client‐owned dogs with GBM.

Methods

Multicenter, retrospective study of dogs with GBM, presented from January 2007 to November 2016 to 6 academic veterinary hospitals in the United States. Interrogation of hospital databases identified all cases with the inclusion criteria of a gross and histopathologic diagnosis of GBM after cholecystectomy and intraoperative bacteriologic cultures of at least 1 of the following: gallbladder wall, gallbladder contents, or abdominal effusion.

Results

Two hundred and nineteen dogs fulfilled the inclusion criteria. Dogs with GBM and gallbladder rupture with bile peritonitis at the time of surgery were 2.7 times more likely to die than dogs without gallbladder rupture and bile peritonitis (P = 0.001; 95% confidence interval [CI], 1.50–4.68; n = 41). No significant associations were identified between survival and positive bacteriologic cultures, antibiotic administration, or time (days) from ultrasonographic identification of GBM to the time of surgery. The sensitivity, specificity, positive, and negative likelihood ratios for ultrasonographic identification of gallbladder rupture were 56.1% (95% CI, 39.9–71.2), 91.7% (95% CI, 85.3–95.6), 6.74, and 0.44, respectively.

Conclusion and Clinical Importance

Dogs in our study with GBM and intraoperative evidence of gallbladder rupture and bile peritonitis had a significantly higher risk of death. Additionally, abdominal ultrasonography had low sensitivity for identification of gallbladder rupture.     

The Diagnosis of Pancreatic Degenerative Atrophy in Dogs – a Practical Method

A convenient method was developed to diagnose pancreatic degenerative atrophy (PDA) in small animal practice based on the observations, that feeding crude soybean increases faecal protease activity in dogs with normal pancreatic function, while PDA-dogs remain completely negative in faecal protease activity.When PDA is suspected, 1 or 2 faecal samples should be investigated with the X-ray film method based on incubation for 2 h at 37°G. If any activity is seen the dog should be considered non-PDA. If no activity is seen the dog should be given food supplemented with 1 g crude soybean/kg body weight twice daily for a few days and a new faecal sample should be collected. If the activity remains negative the diagnosis of PDA is reliable.As the amount of crude soybean in the food increased, a dose dependent increase of faecal protease and amylase was seen as measured with the radial enzyme diffusion method (RED).     

Corneocyte Counts for Evaluation of Antiseborrheic Shampoos in Dogs

Abstract— An objective method for measuring corneocyte numbers before and after antiseborrheic shampoo therapy was assessed in dogs. Corneocytes were collected from six skin regions on the dorsal trunk of nine colony-raised beagles with clinically normal skin. Forty-eight collection sites were randomly assigned a treatment with one of seven medicated shampoos or water alone; six additional sites served as non-treated controls. Corneocytes were collected immediately before the first treatment, and 14 and 28 days after initiation of therapy with a 0.1% Tween 80 surfactant and a quantitative cup-scrub technique. Pretreatment corneocyte counts were not significantly different among the nine dogs nor among the randomly assigned treatment and control sites (3.55 · 10⁴ cells.cm^-2, SEM 0.17). Corneocyte counts increased in all treatment and control sites from days 0 to 14. Corneocyte counts were similar in the non-treated and water-treated sites from days 14 to 28. Corneocyte counts were not significantly different when the same treatments were compared on days 0, 14 and 28, or when different treatments were compared on the same day. The corneocyte collection technique used in this study proved to be a reliable method for assessing the rate of cell desquamation and cell surface cohesion in dogs.     

Pancreatic Degenerative Atrophy and Chronic Pancreatitis in Dogs a Comparative Study of 60 Cases

During the years 1977–1980 60 cases of non-neoplastic chronic exocrine pancreatic disease in dogs were investigated clinically and pathologically. The disorders were clinically divided into pancreatic degenerative atrophy (PDA) and chronic pancreatitis. Fifty dogs had PDA and 45 of them were German shepherd dogs. The PDA cases formed both clinically and pathologically a homogeneous group except for 1 case. All the dogs had maldigestion and protease activity was absent from the faeces. General inanition and highly atrophic pancreas were the most typical macroscopic findings. Histologically the exocrine pancreas contained atypical acinar tissue and mononuclear cell infiltrations. Five of the dogs died spontaneously, 4 of them had intestinal torsion and 1 had paralytic ileus.There were 10 dogs with chronic pancreatitis. This group was rather heterogeneous both clinically and pathologically. The pancreas was slightly enlarged and the consistency was firm. The histologic picture was one of fibrous tissue proliferation and inflammatory cell infiltrations in the interstitium. The dogs nutritional state as well as faecal protease activity were normal.     

冕宁县犬细小病毒病初报

冕宁县今年出现犬呕吐、排黄色生蕃茄红色粪便，特别腥臭，病犬多在1－7日内死亡。白细胞和血清总蛋白减少，取回肠切片检查发现上皮细胞内有嗜酸性核内包涵体，初步诊断为犬细小病毒病。预防采取清洁、消毒、疫苗接种等综合措施。治疗采用高免血清和对症疗法相结合、治愈率可达50％－92．7％。     

Plasma Antithrombin Activity as a Diagnostic and Prognostic Indicator in Dogs: A Retrospective Study of 149 Dogs

Background: Antithrombin (AT) is the major inhibitor of coagulation. In people, hypoantithrombinemia is associated with hypercoagulability, thrombosis, and poor prognosis. Veterinary studies, however, have not demonstrated similar prognostic significance. Thus, AT activity (ATA) in dogs currently is interpreted based on human medicine guidelines. Hypothesis: ATA can serve as a prognostic marker in dogs, as has been shown in people. Objectives: (1) To describe the clinical and clinicopathologic findings, diagnoses, and outcome of dogs with decreased versus normal ATA, (2) to identify diseases and mechanisms associated with hypoantithrombinemia, and (3) to assess ATA as a prognostic indicator. Animals and Methods: Retrospective study of 149 dogs with ATA measurement during their disease course. Results: Hypoantithrombinemic dogs had a higher proportion of leukocytosis, hemostatic abnormalities, hypoalbuminemia, and hyperbilirubinemia versus dogs with normal ATA. Hypoantithrombinemia commonly was present in immune‐mediated hemolytic anemia (IMHA), pancreatitis, hepatopathy, and neoplasia. It was associated with higher risk of mortality in the entire study population and for specific diseases (eg, IMHA, neoplasia). The odds ratio for mortality significantly and progressively increased when ATA was <60 and <30% (9.9, 14.7, respectively). A receiver operating characteristics analysis of ATA as a predictor of mortality showed an area under the curve of 0.7, and an optimal cutoff point of 60% yielded sensitivity and specificity of 58 and 85%, respectively. Conclusions and Clinical Importance: In dogs, ATA <60% indicates increased mortality risk, similarly to human patients, but ATA has limited value as a single discriminating factor in the outcome.